Atrial Fibrillation Linked to Dementia, Especially When Diagnosed Before Age 65 Years

This prospective, population-based cohort study leveraged data from 433,746 UK Biobank participants (55% women), including 30,601 with AF, who were followed for a median of 12.6 years
Incident cases of dementia were determined through linkage from multiple databases.
Cox proportional hazards models and propensity score matching were used to estimate the association between age at onset of AF and incident dementia.

During follow-up, new-onset dementia occurred in 5898 participants (2546 with Alzheimer's disease [AD] and 1211 with vascular dementia [VD]), of which, 1031 had AF (350 with AD; 320 with VD).
Compared with participants without AF, those with AF had a 42% higher risk for all-cause dementia (adjusted hazard ratio [aHR], 1.42; P < .001) and more than double the risk for VD (aHR, 2.06; P < .001), but no significantly higher risk for AD.
Younger age at AF onset was associated with higher risks for all-cause dementia, AD and VD, with aHRs per 10-year decrease of 1.23, 1.27, and 1.35, respectively (P < .001 for all).
After propensity score matching, AF onset before age 65 years had the highest risk for all-cause dementia (aHR, 1.82; P < .001), followed by AF onset at age 65-74 years (aHR, 1.47; P < .001). Similar results were seen in AD and VD.

IN PRACTICE:

The findings indicate that careful monitoring of cognitive function for patients with a younger AF onset age, particularly those diagnosed with AF before age 65 years, is important to attenuate the risk of subsequent dementia.

https://www.medscape.com/viewarticle/998428

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